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Contraception » contraceptive patch

contraceptive patch (evra)

The patch contains two hormones - oestrogen and progestogen.

How effective is it?

If the patch is used according to the instructions it is over 99% effective.
This means that less than 1 woman in a 100 will get pregnant in a year.

How does it work?

The main way the patch works is to stop the ovaries from releasing an egg each month (ovulation).

Where can I get the patch?

In Dumfries and Galloway you an get the patch from your GP, your local sexual health services or a C2U drop-in if you are under 20.

Can anyone use the patch?

Not everyone can use the patch. Although there are some medical conditions that would mean you should not use the patch, decisions often depend on a combination of age, smoking, the severity of any medical condition, whether there are other health problems and sometimes your family history of illness. Each woman’s situation is different and your doctor or nurse will be able to advise you.

Conditions which may mean you should not use the patch.

Many women who cannot use the patch are often able to use contraception which only contains the hormone progestogen. This can be taken as the progestogen only pill, implant, injection or hormone coil. There is also contraception that doesn’t contain any hormones such as a copper coil, condoms and diaphragms.

How old do I have to be to start the patch?

Once your periods have started you can use the patch. Some young women use the patch who are not having sex but need help with their periods.

Can I only use the patch for a certain length of time or have to stop at a certain age?

If you are well on the patch and nothing changes in your own or family medical history then there would be reason to stop the patch. In fact if you are healthy, do not smoke and there are no medical reasons for you not to use the patch you could take it until the age of 50.

What are the advantages of the patch?

Some of the good things about the patch are:

  1. Usually makes your periods regular, lighter and less painful
  2. May help with premenstrual tension
  3. Reduces the risk of cancer of the womb, ovary and bowel

What are the disadvantages of the patch?

  1. When you start the patch you may get headaches, nausea, breast tenderness, mood changes and some bleeding when you don‘t expect it. These normally stop within the first few months but if you are concerned or these symptoms continue then talk to a nurse or doctor about it.
  2. The patch may increase your blood pressure and this will be measured regularly.
  3. The patch does not protect you against sexually transmitted infections and many women choose to use condoms as well.

The patch can have some serious side effects which are not common. These include:

Venous thrombosis
The risk of a venous thrombosis is greatest during the first year that you use the patch and if any of the following apply to you: you are very overweight, are immobile for a long period of time or use a wheelchair, have severe varicose veins or a member of your immediate family had a venous thrombosis before they were 45

Arterial thrombosis
The risk of arterial thrombosis is greater if you smoke, are diabetic, have high blood pressure, are very overweight, have certain sorts of migraines or a member of your immediate family had a heart attack or stroke before they were 45.
You should see a doctor straight away if you develop any of the following symptoms whilst using the patch:

How do I use the patch?

You apply a new patch once a week, every week for three weeks (21 days). You then stop using the patch for seven days (patch-free week). This is called a patch cycle.

Where do I put the patch?

You can use the patch on most areas of your body as long as your skin is clean, dry and not very hairy. You should not put it on skin that is sore or irritated or anywhere that can be rubbed by tight clothing. Don’t put it on your breasts. It is also a good idea to change the position of each new patch to help reduce the chance of any possible skin irritation.

Am I protected from pregnancy during the seven-day break?

Yes. You are protected if:


What if the patch falls off?

The patch is very sticky and should stay on. It should not come off in the shower, bath, hot tub or sauna, or during swimming or exercise. However, if it does come off, what you need to do will depend on how long it has been off.

Less than 48 hours

If the patch has been off for less than 48 hours:

48 hours or more

If the patch has been off for 48 hours or more:

Ask your doctor or nurse for advice if you have had sex in the previous few days and were not using a condom as you may need emergency contraception.

What if I forget to take the patch off at the end of week one or week two?

Less than 48 hours

If the patch has been on for less than 48 hours:

48 hours or more

If the patch has been on for 48 hours or more:

Ask your doctor or nurse for advice if you have had sex in the previous few days and were not using a condom as you may need emergency contraception.

What if I forget to take the patch off at the end of week three?

Take the patch off as soon as you remember, have a patch-free break and start with a new patch on your usual start day even if you are bleeding. This means that you have a shorter number of patch-free days than usual. You will be protected against pregnancy and do not need to use any additional contraception. You may or may not bleed on the patch-free days.

What if I forget to put on a new patch at the end of the patch-free week?

This is the most risky time to forget to put on a patch. Put on a new patch as soon as you remember. This is now the beginning of your new patch cycle. You will now have a new day of the week as your start day and change day.
If you put on the new patch 48 hours or more after your usual start day then you may not be protected from pregnancy. Use an extra method of contraception, such as condoms, for the next seven days. If you had sex in the previous few days and were not using a condom ask your doctor or nurse for advice as you may need emergency contraception.

If I take other medicines will it affect the patch?

There are a few medicines that make the patch less effective. If you are prescribed any new medication you should tell the doctor or nurse that you are using the contraceptive patch so that they can check to see if there are any interactions.

Commonly prescribed antibiotics do not affect the patch. However some drugs can reduce the effectiveness of the patch and increase the chance of getting pregnant. These include certain drugs used to treat HIV, TB and epilepsy as well as the herbal preparation ‘St John’s Wort’. If you are taking any of these tablets you should speak to your doctor about the contraceptive options available to you. . Ella-One should be avoided if you are on hormonal contraception and if you are given Ella-One because you haven’t used a patch for a few days, you should not restart the patch for another 5 days. It will then take a further 7 days until you have effective contraception so you should abstain or use condoms for this time

Finally

It is important that you are happy with the type of contraception you choose to use. Doctors and nurses are trained to work with you to find a method of contraception that suits you. Do not be afraid to discuss any concerns you may have.